Juniper publishers have been established with the aim of spreading quality scientific information to the research community throughout the universe. We, as Open Access publishers, strive to offer the best in class online science publications. Open Access process eliminates the barriers associated with the older publication models, thus matching up with the rapidity of the twenty-first century. Our main areas of interest lie in the fields of science, engineering and other related areas.
Showing posts with label Juniper publishers open access journals. Show all posts
Showing posts with label Juniper publishers open access journals. Show all posts
Hemodynamic monitoring has built its developement on the needing to know whether enough oxygen from the lung reaches the cells and carbon dioxide flows back to be excreted. Since they travel within the blood flow, attention focused on the amount of blood circulating through the vessels (i.e. the volemia) and how it circulates. But our habit is still to use "old and static” parameters (central venous pressure, pulmonary capillary wedge pressure) or only blood pressure and heart rate to guide our fluid therapy. One reason may be that we are still not so confident with new technology of hemodynamic measurement, in many cases. Another cause may be the incredulity towards the new devices. There is a big gap between clinical research studies evaluating these monitors and clinical practise that need to be filled by unquestionable results derived from large multicenter trials in order to break the fog that causes doubts and perplexities in their use.
«Not everything that counts can be counted and not everything that can be counted counts»
Upper gastrointestinal bleeding (UGIB) is common and potHemodynamic monitoring has built its developement on the needing to know whether enough oxygen from the lung reaches the cells and carbon dioxide flows back to be excreted. Since they travel within the blood flow, attention focused on the amount of blood circulating through the vessels (i.e. the volemia) and how it circulates. We learned that blood volume is the sum of intra-vascular volume and blood circulating into the organs (i.e., tissue perfusion) and represents almost 10% of body weight. A normal "standard” adult subject has 5-7 L of blood, near 70% of which circulates into the veins, [1]. Volemia undergoes a complex regulation which involves the neuroendocrine system, the gastrointestinal apparatus, kidneys, lungs, bone mARGHow and skin: they regulate the input and output of fluids, the hematocrit and blood components, [1]. Simplifying to the maximum, when output is greater than input we tend to replace the loss with fluids.
The first time a fluid was intravenously administered was during the Cholera pandemic of the XIX century, [2]. Then the normal saline solution 0.9% was reported as the best fluid and was adopted worldwide, [3]. During the 1920s physicians started to use Hartmann's Solution, nowadays named Ringer Lactate. Finally, after the Second World War, Human Albumine entered the list of fluids for shock treatment, [4,5]. As that list got longer, the choice of treatment became more and more debatable, because each fluid has own characteristics and different effects on hemodynamics.
"The decision to administer supplemental intravenous fluids to the patient at risk is built upon the belief that additional volume expansion will, or will not increase cardiac output.”, [6]. In fact, when circulatory instability occurs, generally we aim firstly to restore the cardiovascular balance giving fluid to the patient, without caring of the long-term consequences (i.e. organ failure and mortality).This habit has been revisioned and debated during the last decade, particularly about hydroxyethyl- starch (HES) and 0.9% saline solution, [7]. To complicate the issue the "Boldt Case” broke out, [8].
Some questionsarise. May be correct to think that many conclusions arisen from the studies of Boldt were wrong?What do we do withthe informations derived from those trials?Several medicine text-books reported those conclusions. Those books need to be rewritten? Furthermore, we cannot use HES anymore so widley after its restrictive indications were released, [9]. Then, how can we be sure that the results from those trials, which also studied HES-based fluid therapy, can be still appliable bed-side?
Time break. Let's go back again to Physiology. When we try to measure blood volume we refers to circulating blood volume (CBV) and mainly to the portion that perfuses organs, the so called Effective Circulating Volume (ECV) of the arterial circulation. It depends not only on Cardiac Output (CO) but on vascular resistances too, [10]. Often we refer to Volemia as CBV and we try to measure it by several devices. Since our main target is to know whether a sufficient amount of blood reaches the cell (i.e. tissue oxygen delivery), Technology focused its production on arterial measurement systems or cardiac function assessment. Many devices provide data about blood flow fluctuation during respiration to predict fluid responsiveness (FR), forgetting the venous side of the circulation, where near 70% of volemia circulates. We know that CO depends also on venous blood return (VBR), [1]. Ultrasound measurement of inferior vena cava (IVC) diameter and its variation during the phases of respiration (i.e. Caval Index, CI) may be an acceptable compromise to know how much blood goes back to the right side of the heart. But also Cl has its own limitations that if forgotten provide mis-interpretation [11].
Out of such an amount of hemodynamic measurement systems how many times do we use them to guide our fluid therapy (FT) bed-side? Cecconi et al., found that most often we still adopt only blood pressure (BP), heart rate (HR)or Central Venous Pressure (CVP) as guides for FR (near 70% and 24% and 57% of cases, respectively) [12].
Three possible answers: 1) We use BP and HR as guides for FT because we have not advanced monitoring system in our hospital; 2) We still use BP and HR because we are not confident with other measurements and/or we don't believe in such devices; 3) Routinely we use BP and HR but in case of very complicated clinical situations we employ advanced tools.
Despite the first response may translate into dangerous management of critically ill patients, it could be the Institutional Policy with a view to cost saving (particularly in a little peripheral hospital), forgetting that even the complicated patient is spending. The second answer may derive from a not sufficient participation to educational courses about hemodynamic monitoring. Most often such events are very expensive and each Department could permit few staff doctors to participate, unless the physician does so at his own expense or by sponsors.
The main cause of the unbilief on device measurements, particularly the less invasive ones, may be the inconclusive Literature about their validation trials [13]. The third situation may be the most dangerous. In fact, waiting for an advanced crtitical condition to adopt a closer monitoring may be life- threatening. Early goal directed fluid therapy provides a better outcome but need to be monitored to reach the aim of life saving and cost-saving [14,15]. Finally, different hemodynamic impairments and patients may require an appropriate type of tool. Not every type of monitoring system fits every type of critical patient. If we face with pulmonary hypertension, Pulmonary Artery Catheter may be the correct choice, but in case of adult respiratory distress syndrome (ARDS) it may be very helpful to know the extravascular lung water (EVLW), for instance, and then Transpulmonary Thermodilution technique may be the best option. Hence the needing to be confident with different hemodynamic tools to do the best choice according the clinical situation may be the best policy and of common sense.
In summary, we try to measure something that we don't know so well by devices not always reliable, invasive (and potentially dangerous for the patients) and expensive, to which we are not so confindent in many cases. Conversely, several studies showed that monitoring fluid therapy (whatever the system we choose) may save many lives and then be economically saving. Hence, we have to use instruments to know merits and defects but in which we trust and make them the guide of our therapy, if properly validated: we can read too much trials including few patients, published also in Journals with high impact factor
On the other hand, Technology-Hemodynamics educational courses should be less expensive to contribute to a wider adoption of such devices, even in little hospitals where treat critical patients is more difficult and forces doctors to tranfer the patient (i.e. cost expensive) to a greater hospital where he may receive the best treatment. To quote M.R. Pinsky and D. Payen, monitoring does not save life by itself, [16]. But it may be reasonable to think that monitored therapy does, as long as we know what to measure and how [17]. It may be very difficult and dangerous to treat not well understood clinical situations, monitored by inaccurate tools. Just like a piloting an airplane with an inaccuarate altimeter. There is a "...big gap between clinical research studies evaluating these monitors and clinical practise” [17], that need to be filled by unquestionable results derived from large multicenter trials in order to break the fog that causes doubts and perplexities in their use.
The best quality of someone or something that creates something valuable can be considered as virtuous. The present article frames the engineering ethics, what I call the virtuous engineering, from the civil engineering perspective. Civil engineering can be comprehended in the sense of imagining, innovating and creating such structures and designs which not only make social life more convenient but also civilized. The engineering skills and virtues it involves in its engineering designs and structures represent the character of the society. From the ancient Giza Pyramids to the latest Qingdao Halwan Bridge all narrates the beauty, virtues, skills, techniques, challenging will and civil engineering attitude of their societies. The article construes the ethical enhancement in the civil engineering as a mark of social developments. The article is innovative and explorative in its analysis in the fashion it involves engineering ethics, aesthetics and socio matrix in understanding the civil engineering creativity
Aristotle defines about the virtues as characteristics having their purpose to achieve what they aimed to. And, when we are virtuous in terms of what we do actually we realize a state of mind filled with happiness that's what he calls Eudemonia. Engineering creations in general and civil engineering in particular have to focus on this engineering ethics as it is the need of hour to maintain a grater balance of good through engineering creativity. The mantra of any industrious act, whatever it involves whether the engineering or the business corporate proceedings, is to maintain the Triple bottom line:
1) People,
2) Planet and
3) Profit.
Following the same line of thinking the paper has a vision of civil engineering in which it defends that the civil engineering is not only an act of engineering but also it represent the social character. Hence, the great civil engineering designs, structures, and achievements all they act as representative benchmarks for the society and to the idea of social development. The emphasis has been put more on the ethical side of civil engineering in a manner it really involves the ethical ideas to make social life civic by providing such civil engineering creations that give to society a morally better and healthy life; let's talk about the very basic concept of room having doors and windows what these structures facilitates in terms of making a better moral life that is having privacy with the choice of exposure. In this explorative effort I shall be concluding with the remarks that the future of civil engineering is of Green ethical engineering which encapsulates the virtuous creativity, Happy Society and Environmental Safety.
From the ancient time creativity has been shaped by the human mind through natural beauty and its underlying aesthetic philosophy. However, there is a gradual fall down in this kind of engineering thinking. And it has alarmed us to restructure the engineering view before we imagine creating any technology, machine, design or structures. The need of hour is the virtuous engineering modal which not only encompassing the basic engineering skills but also the engineering ethics that it should be in order to facilitate a society in making the social life more convenient, civilized, and healthy. Let 2019;s talk about the Giza Pyramid; the oldest civil engineering wonder of the world. Alexander writes:
In the ancient world there once stood seven wonders, seven monuments of the ingenuity of men. The civilizations fell, and those wonders crumbled to dust, lost in the sands of time all except one: The Great Pyramid of Giza. It is spawned countless myths, but its real story is about triumph over impossible odds, extraordinary human ingenuity and one man's burning ambition to live forever. It is 4.500 years old, the only ancient wonder of the world still standing and it is the oldest [1].
How specialized civil engineering skills being personified in the creation in terms of aesthetics, skills and engineering design. The famous Arabic proverb philosophically states:
Man fears the time, but the time fears pyramids [1].
The purpose of the pyramids was religious however it exemplified the world-class civil engineering design. The oldest civilized burial system with structural protection and enhanced social respect and security shows the ethical engineering philosophy inbuilt in the built structures.
Let's talk about the most recently civil engineering structure of the current time: Qingdao Halwan Bridge built by China. The world 2019;s longest cross Sea Bridge recorded in the Guianese Book. Purposefully connecting the eastern and western of the Qingdao regions in China represents the industriousness and top civil engineering creation. And, this gigantic creation will be an international shipping center of North-East Asia. However, this and the other recent civil engineering creations are missing what is the purpose of this explorative paper and that is engineering without ethical virtues [2].
This is the very difference that has been glared in the recent past civil engineering will to create world class designs and structures that earlier in the ancient times the engineering creations were holistic in the way they value not only technology , innovation and creation but also the ethics, environment and earth; protecting nature from the damage. The socio-economic development of Qingdao city and the civil engineering creation around have put the coastal and marine at stake [3-5].
The very ancient Indus Valley Civilization is honorific example of value based civil engineering. In this we find the houses, roads, sanitation mechanism, and big structures for collective celebrations such as Great Bath at Mohenjo- daro. The engineering will and the social character it reflects in the structures and design tells all the story that the civil engineering of that time was ethically equipped with good social development. The centralized governance system was found in the civilization and well functioning as the measurement units were almost same in all the engineering creations.
We have to understand the above as social developments through civil engineering creations. All the above examples from ancient to the Modern civil engineering is to make the contrast in terms of the understanding that the time has come to realize that the ancient holistic civil engineering philosophy based on the protection of nature and society is the way out to the existing social-environmental problems. Hence, we need to be virtuous in our civil engineering imagination. Before we create anything or think about any technological advancement in the stream. We should focus one of the purposes of civil engineering: Creating better societies and reflecting it in their structures and designs in the fashion that they actually revels the ethical character of the society in their engineering mask and make ups as expressed in the figure below [6].
Virtue theory was developed by Aristotle and he argues from the Arete that is the moral excellence. It is the highest virtue. Aristotelian virtue theory gives directions to civil engineering for this time is to incorporating the genuine imagination, aesthetics, innovation in civil engineering without the thinking of the use and profits. According to him every human endeavor has a purpose to express the virtues and qualities by which it should be performed and further the expressed virtues have a purpose and it is to create a better society. So, civil engineering creativity has a larger purpose and that is to create a better society and better world to live in [7].
Jeremy Bentham in his view of Utilitarianism says that we should act on the principle of utility in maximizing goodness for maximum number of people. Later on the theory was strengthened by his disciple John Stuart Mill who added the qualitative aspects in terms of making higher order choice in choosing what is of utility. Taking the ethical point of view the recent civil engineering philosophy should buy the reasons given by Mill in his Utilitarianism that the creativity should be such that it should not only be maximizing the social utility and happiness but also respecting social health and natural environment as qualitatively better choice [8-10].
Extracting the ethical points from the Deontology we can recommend for the civil engineering that the virtue and the utility are not the two crucial factors only for the engineering imagination and engineering will but the imagination should be responsible in terms, that it take care of the duties which are adhered to the engineering profession. Such duties involves duties to be truthful to profession, integrity and careful to humankind and society Figure 1.
The great message from this point of view is to engineering design is that we should not exploit anything only for the results. We should have good intentions in our creativity without having the will to use nature as means only or to exploit the society for maximum profits. We should be rational in our engineering creativity that whatever we create should offer ethical space to the society. Crafting a good ethical design from the above ethical point of views we can reasonably say that the civil engineering creativity should be virtuous and serving to the social utility and be dutiful to the professional responsibilities.
Canvassing the several explorative reasons from Aesthetics, Ethics and Socio-matrix, I have made an effort to write this guiding article in the time when actually it is very much needed for engineering creativity in general and for the civil engineering creativity in particular. The message is very clear that the engineering imagination and creativity in the civil engineering should accommodate the triple bottom line and it should be holistic in its creation like the ancient civil engineering structures and designs. The world of engineering of this time is facing several challenges because it does not encompass the concerns of ethics, environment and society [11].
The duty of the civil engineering domain is very high because it's leading engineering from the very ancient time in making humanity more equipped and civilized through creating the required engineering structures and designs. The research, technology and any such valuable effort in the civil engineering direction should take it as a policy matter that without involving ethics, aesthetics and integrity to the engineering profession a good engineering creativity structure or design cannot qualify the benchmark of the real engineering creativity. Civil Engineering represent the social character and it structures and designs represents the skill, strength and engineering will of the society [12].
Therefore, the entanglement of ethics, aesthetics and social-matrix should be structured in a manner shaping the civil engineering as an exemplary engineering creativity. The creativity that reflects aesthetic taste, ethical judgment and Eudemonia of such that society enjoys the creation with all happiness considering the global safety it should be harmless and holistic to the nature. And, in this way coming age and technologies should make a paradigm shift in civil engineering from mere engineering creativity to Green Virtuous Engineering Creativity. The coming research imagination should incorporate these ethical, aesthetical, and social reasons to form the future civil engineering designs and structures.
This study was designed to determine whether pulsed electromagnetic field therapy (PEMFT] could alleviate common symptoms of arthritis such as pain, swelling and immobility and whether it could contribute to overall wellbeing. Five volunteers, all of whom were diagnosed with osteoarthritis, participated in the study. Subjects treated themselves with the Centurion EZY system for 20 minutes, two to three times per week for four weeks. Subjects were tested for various physiological parameters including blood pressure, heart rate variability, balance of the autonomic nervous system (ANS), and stress at the beginning of the trial and at the end. An electro-interstitial scan was conducted to provide additional wellness parameters and a photograph was taken to document range of motion. Results were assessed on a case-by-case basis. PEMFT improved mobility in two of the cases after just one treatment and reduced pain and/or swelling in four of the five cases within 4 weeks. Additionally, general wellness related to cardiovascular health and balance of the ANS of participants improved throughout the course of the study. PEMF therapy may be a useful form of therapy to promote healing and to reduce symptoms of pain, swelling and immobility among patients with osteoarthritis. Furthermore, these treatments may have overall benefits to the health of the cardiovascular and the autonomic nervous system. Further testing needs to be done with a larger sample size to confirm these initial findings.
Arthritis is a degenerative disease characterized by joint pain [1]. People suffering from severe forms of arthritis experience an impaired quality of life and are faced with few treatment options that provide long-term relief [2]. The most common types of arthritis are osteoarthritis and rheumatoid arthritis, the former of which is the focus of this pilot study.
Osteoarthritis is a dynamic but gradual disease that can ultimately lead to loss of joint function or significant disablement [3,4]. Currently, there is no cure for arthritis, and treatment options focus mainly on symptom management [1].
Traditional options for treating arthritis include oral non-steroidal anti-inflammatory drugs (NSAIDS), acetaminophen, and corticosteroid injections; which come with side effects such as abdominal pain and damage to central organs [5-7]. Non- pharmacological treatments include diet management to reduce strain on the joints, exercise to improve mobility, splints and joint protection techniques, hot and cold therapy, chiropractics, physiotherapy, acupuncture and more invasive treatments like surgery [1,6]. The relative lack of viable long-term non- pharmacological treatments for arthritis combined with the risks of drug therapy provided the motivation for this study, especially since past studies involving pulsed electromagnetic field therapy (PEMFT) have found no adverse effects on the body, even after prolonged use [8].
PEMF technology was officially approved by the Food and Drug Administration (FDA) in 1979 and has been used to treat various ailments and illnesses for the past 50 years [9]. The therapy was originally used to treat non-union bone fractures and is now used to treat rotator cuff tendinitis, peripheral nerve regeneration, and various other illnesses and ailments of the bone and ligaments causing pain and swelling [10]. Since PEMFT has been recognized to improve circulation and promote healing of inflammation-related pain [1], it shows promise as a treatment for arthritis. Using PEMFT to treat patients with arthritis is not common practice [1,6] and has not been approved by Health Canada. This study attempts to determine if PEMFT (provided by the Centurion EZY System) can alleviate symptoms of arthritis such as pain, swelling and immobility, based on a combination of subjective and objective tests.
Trent University Research Ethics Board approved this research. The study was performed as a clinical trial and participants were responsible for treating themselves following a short-introduction on how to use the PEMF technology.
This study monitored five participants with osteoarthritis all of whom volunteered to be tested. One male and four females between the ages of 60 and 72 were included in this study. These participants were recruited at a local chiropractor's office, where the study took place. All participants were receiving chiropractic care prior to, and throughout the study. Initially, an information session was held at the chiropractor's clinic and nine potential participants arrived, but only seven were present at initial testing, five of whom had diagnosed osteoarthritis. Symptoms of the subjects differed and each participant was monitored individually. Participant codes were used to maintain anonymity throughout the study with age and gender being part of the code. Participant information is provided in (Table 1).
The PEMF device used in this study is the Centurion EZY system, which is intended for home use. The portion of the body to be treated is placed within the device, which is a cylinder large enough to fit around the whole body (Figure 1). The device is easy to use, which allowed participants to treat themselves. Two buttons on a remote attached to the cylinder enabled the user to adjust pulse frequency (from 2, 8, 15, and 30 pulses per second) and duration of treatment (20, 30 to 60 minutes). Participants were instructed to use the therapy two to three times each week over the course of four weeks in the local chiropractic clinic.
All participants began with a treatment at 2 Hz for 20 minutes. The frequency was increased to 15 Hz for an additional week and to 30 Hz the following week provided no adverse symptoms were experienced. None of the subjects experienced adverse symptoms related to PEMFT during the study.
In order to eliminate the placebo effect, two different Centurion devices were used (labeled A and B). Each participant was assigned to one of the two devices, and all participants were told that one device was non-functioning. In reality, both devices were fully functioning and therefore allowed us to treat all participants while minimizing the placebo effect.
Before and after each treatment, participants completed a questionnaire where they rated their symptoms on a scale of 0-10 for each location of arthritis that was being treated. For example, if a participant experienced pain, and immobility; they would rate their pain and immobility before and after each treatment on an increasing scale of 0-10 (where 10 is the most severe). Participants were also contacted weekly to document their experience. General questions asked were:
i. Have you experienced any changes in symptoms over the last week?
ii. Has the device caused any discomfort?
iii. Have you experienced any change over the course of the study?
Subjects were tested for various health parameters at the beginning and at the end of the four-week study. Devices used included blood pressure monitoring; Max Pulse to monitor heart rate variability and to provide information on stress response; ESTeck to assess the interstitial environment; and photography to document changes in mobility, swelling, and disfigurement. Each participant was monitored before exposure to PEMF therapy and at the end of the four-week study. These monitoring techniques are described below.
We photographed each subject to document changes in range of motion and deformities at the beginning and at the end of the study. We also photographed subjects after their first 20-minute treatment to determine immediate changes, if any.
Max Pulse is an FDA Class II medical screening device that provides measurements using photoelectric plethysmography, accelerated plethysmography, and other technologies to access overall cardiovascular and ANS wellness. It provides information on the relative balance of the sympathetic and parasympathetic autonomic nervous system (ANS), stress level, condition of blood vessels, and heart health (Medicore, Max Pulse User Manual).
The ESTeck electro-interstitial body-scan works in conjunction with the data from the Max Pulse to provide an assessment of overall health (www.ldteck.com). ESTeck is commonly used by healthcare practitioners to track changes in a patient's health and wellbeing. ESTeck provides information about heart rate variability, heart rate, stress, systolic and diastolic pressure, systematic vascular resistance, dissolved blood oxygen, blood volume, maximum oxygen volume, and a homeostasis score. Analysis involves bioelectrical impedance. From this, it is easy to see progression or regression in each field in order to determine if health is changing. For ESTeck assessments, the patient is seated with feet and hands placed flat on separate metal sensor plates, and with two electrodes positioned on the forehead above the eye brows. A finger pulse oxy meter probe is used to estimate percentage of hemoglobin that is saturated with oxygen (SpO2). Additional information provided for this program to operate optimally is age, gender, height, weight, blood pressure, ethnicity and level of physical activity.
Case 1 is a 64-year-old female who was diagnosed with arthritis in the hands and feet 34 years ago. She is five feet tall, 165 pounds, and reports very light daily activity. The participant experiences symptoms of arthritis throughout her body and also experiences pain and mobility issues in her arms. Case 1 suffers from severe finger and hand and foot deformities and had the most advanced arthritis in the study (Figure 2). Her major concerns were weakness and immobility (Table 1). This individual received a total of nine 20-minute treatments to shoulders and feet.
Changes following PEMFT are indicated by symbols for better (+) and worse (-) for each case.
Initially, Case 1 could not form a fist and had difficulty raising her right arm above her head and both arms behind her back. After an initial treatment she could form a fist and had more mobility of her arms that continued to improve with time (Figure 3). Mobility of her feet also improved slightly. Weakness was a major concern and there was some evidence that 15 Hz frequencies alleviated some of her weakness especially in her hands and arms. Despite the fact that Case 1 had the most advanced form of arthritis, improvement in mobility was both rapid and dramatic, which shows promise for those with severe arthritic symptoms. Case 1 also experienced reduced physical and mental stress during the study (Table 2). PEMFT significantly reduced arthritic symptoms for Case 1. She has elected to continue with treatments beyond the four-week test period.
Case 2 is a 60-year old female with arthritis in the left hand and right shoulder that was diagnosed approximately seven years ago. The individual is 5 feet 8 inches and 160 pounds, and reports about two hours per week of physical activity. Arthritis in the left hand has produced a finger deformity in the pointer finger, and the Case 2 notes that the pain from this finger has been spreading to other fingers over the past several months. This individual attends physiotherapy once weekly, but did not attend physiotherapy for two weeks during this study, and upon returning to the physiotherapist the doctor noted that mobility had improved during that time. Note that this individual stopped doing physiotherapist-recommended exercises at home, and the improvement occurred while the participant was using the PEMF therapy. This individual received a total of 12 treatments.
The progression of photos for Case 2 show that her right arm was able to extend slightly further in the "after 1 treatment" photo, and was able to extend significantly further in the "after 12 treatments" photo (Figure 4). The hand images for Case 2 show improved mobility in the fingers after the first treatment and she experienced significantly less pain and less swelling of both hands and shoulder following PEMF treatment. Mental stress reduced and stress resistance increased for Case 2 based on Max Pulse HRV (Table 2). Clearly PEMFT reduced symptoms of arthritis experienced by Case 2 and also reduced her level of mental stress. She has also elected to continue with weekly PEMF treatments.
Case 3 is a 61-year-old female who was diagnosed with osteoarthritis in the neck and lumbar 12 years ago. This participant suffered from mouth cancer in the past, and the radiation treatment for this left her with chronic jaw pain. Case 3 is 5 feet 2 inches, 120 pounds and has a moderate activity level. She received 13 PEMF treatments in total. Case 3 experienced a slight decrease in pain and swelling of her neck and a decrease in swelling of her lumbar region following PEMFT but no noticeable change in mobility, which was her major concern. This subject had a significant decrease in mental stress (Table 2) and considerable improvement in six of the nine parameters for her cardiovascular and autonomic nervous system by the end of the study including a normal heart rate, a balance of her ANS based on HRV, and normalized specific oxygen, estimated blood volume and homeostasis score (Table 3). Improved heart rate variability reflects the body's ability to moderate the autonomic system and improved homeostasis score represents the body’s ability to adapt to changes such as disease or illness [11]. While PEMFT did not reduce her primary concern of limited mobility in the neck and lumbar regions, improvements in her cardiovascular health and ANS were noted during this study.
Case 4 is a 72-year old female, who was diagnosed with osteoarthritis in the right shoulder and left knee approximately two years ago. This individual is 5 feet and 148 pounds, and reports moderate daily activity. This individual experiences worse pain in the knee when walking. Case 4 received a total of eight treatments. Her major concerns were with discomfort and immobility, neither of which improved during this study. She reported no noticeable physical changes during the testing period. Mental stress was much lower at the end of the study and physical stress was marginally higher (Table 2). Her ANS was better balanced and her cardiovascular response was mixed (Table 3). Case 4 improved the least of the 5 Cases tested.
Case 5 is a 64-year old male, who was diagnosed with osteoarthritis in the hips, knees and lower back prior to 2012. He also experiences pain from past injuries, including a torn meniscus in the knee and a lower back injury and his symptoms become worse in cool, damp weather. He is 5 feet 10 inches and weighs 212 pounds. This individual received 16 treatments. He increased physical activity and changed his diet resulting in weight loss during the study, which may explain some of the results observed.
His major concerns were pain and immobility (Table 1). A slight but insignificant change was noticed in the pain associated with his hip. Case 5 stated that he experienced slightly better mobility and less pain while walking. Based on Max Pulse, subject showed improvements in both physical and mental stress (Table 2), which was supported by the ESTeck stress index. According to ESTeck, Case 5 shifted from sympathetic to parasympathetic dominance and his blood pressure changed from high to normal (Table 3), which may be due in part or entirely to his weight loss.
The use of magnets for the purpose of healing dates back to Plato, Aristotle and Homer, and during the renaissance, magnets were used to minimize inflammation [1]. In short, this is not a new technology, and is surrounded by a large field of research. The use of magneto therapy began soon after World War II in Japan, and then the technology travelled to Europe [7]. From 1960-1985 it was commonplace for European countries to design and create their own version of a magneto therapy device. During this time, literature on the topic began appearing, the most significant of which treated 2700 patients with 33 different pathologies. In the 1970's, the therapy was used to treat nonunion fractures, and since then it has been approved by the FDA for that purpose. Ten years after the initial approval by the FDA for non-union fractures, the technology was approved for treatment of pain and edema in soft tissues [7]. Prior to approval from the FDA, several trials were performed in order to monitor efficacy, and the success rate of these trials averaged from 7080% [9].
Pulsed electromagnetic field therapy (PEMFT) is a technology that uses pulsed electromagnetic fields to stimulate either a specific area of the body to improve specific symptoms, or the whole body to improve overall wellbeing. The higher the frequency used in the therapy, the more often the electromagnetic fields are pulsed through the device. For example, 2 Hz means two pulses per second, and 30 Hz means thirty pulses per second. Various frequencies and waveforms have been found to have different effects on various disorders [7,12].
PEMFT does not heal the body, but rather aids the body in repairing itself. The exact mechanisms that occur in the body are complex and not entirely understood, however, a large body of science surrounds this topic and there is a general consensus in how and why the therapy works among the research community [7,13].
PEMFs are meant to stimulate piezoelectric potentials using Faraday currents in extracellular fluid [9]. The movement of electrolytes in bone channels and fixed charges generate streaming potentials cause piezoelectric potentials, so the PEMFT is mimicking a natural phenomenon that occurs in the body [14]. In other words, PEMFT generates the same changes within cartilage and bone as natural cartilage compression produced by movement, which causes the fluid and accompanying electrolytes surrounding this cartilage and bone to circulate [14]. This circulation of extracellular fluid is believed to be key in the healing process as influenced by PEMFT.
The use of PEMFs also creates a forced vibration of free ions on the plasma membrane of each cell, which can in turn affect the cell’s electrochemical balance and also its function [15]. As free ions in the extra cellular matrix are circulated, cartilage repair should improve and pain should subside [14,16]. Along with this, mobility should improve as well as minor-to-moderate disfigurements.
PEMFT has also been shown to encourage nerve regeneration in vivo studies, caused by an up-regulation of A2A adenosine receptors, which modifies the response in human neutrophils [16]. Cells in the extracellular fluid as well as cells in nerves are altered, encouraging healthy growth and regeneration, and generally improving healing and well being [9,16].
Today, it is quite common to see PEMFT being used in doctors' offices and clinics to remedy an array of ailments [8]. Studies have confirmed that PEMFT can be helpful in treating osteoarthrosis, abnormal ossification, osteoporosis, nasosinusitis, multiple sclerosis, Parkinson's disease, spastic paresis, diabetic poly neuropathy and retinopathy, vegetative neurosis, peptic ulcers, colon irritable ulcers, trophic ulcers, and several other health complications [17].
The purpose of the current study was to determine whether PEMFT using the Centurion EZY system can alleviate symptoms of osteoarthritis. Of the five cases tested, two experienced significant improvement in mobility by the end of the study and one of these experienced improvement after the first 20-minute treatment. Slight to significant reductions in pain and swelling were reported by four of the five cases. Furthermore, improvement in cardiovascular health and in ANS balance was also observed in four of the cases by the end of the four-week test period.
Several studies have been done over the past several decades to determine if PEMF therapy would be useful to treat arthritis. Overwhelmingly, the conclusion to these studies is that PEMFT would be a valuable therapy to those suffering from various types of arthritis. Human studies that have been conducted include PEMF to treat osteoarthritis in the knee, the cervical spine, osteoarthritis in general, and treatment of various other arthritis symptoms [3,4,8,10,18-21]. Each of these studies were done differently, using different methods and different versions of technology, but all resulted in the conclusion that PEMF technology would be helpful in treating arthritis in some capacity [8]. Some of these papers also looked at the toxicity of using PEMFT, and found that there was no measurable toxicity or side effects to the use of a PEMF device [8].
Experiments have also been performed on various laboratory animals with arthritis and PEMFT is used in veterinary clinics to treat horses and other large mammals as well as small domestic pets for various ailments ranging from broken bones to soft tissue healing to pain reduction. Use of animals to test the technology provides more conclusive evidence of the effectiveness of PEMFT Again, these studies concluded that the technology being used caused no adverse effects and that PEMF therapy may be useful to treat arthritis in humans as well [13,14,22-29].
Additionally, studies have been performed in vitro to determine the effect PEMF has on cells. These studies determined that PEMF exposure could trigger cell proliferation and glycosaminoglycan synthesis in cartilage, thereby altering the extracellular fluid surrounding the cartilage, which encourages healing of the cartilage [30,31].
According to Ganesan [1], analysis of various studies conclusively shows that PEMF not only alleviates arthritic pain but it also affords chondro protection, exerts anti-inflammatory action and helps in bone remodeling and this could be developed as a viable alternative for arthritis therapy. Overall, PEMFT appears to be a promising technology to treat arthritis, and it will be used more frequently in the future.
Pulsed electromagnetic field therapy (PEMFT) is used globally for a number of ailments ranging from rapid recovery following surgery to healing of non-union bone fractures to reduced depression with no obvious side effects after prolonged use. PEMFT has been documented to improve circulation, reduce inflammation and alleviate pain and as such may be a useful treatment for people suffering from arthritis. According to this study, PEMFT, generated by the Centurion EZY system, alters symptoms of arthritis that include some combination of reduced pain, reduced swelling and improved mobility. Responses varied among the volunteers tested with some showing immediate and significant improvements after a single treatment and others are having minimal effects by the end of the test period. PEMFT was also associated with improved overall wellness related to cardiovascular health and autonomic nervous system balance and manifested itself as a form of stress reduction and sympathetic down-regulation. Use of this technology, during the four-week period, resulted in no obvious harmful effects. Clearly, this pilot study needs to be replicated with more cases and a longer test period to verify the results. Should they be verified, PEMFT may be an effective, easy to self-administer, non-invasive treatment with no known side-effects for those suffering from minor to severe osteoarthritis. Benefits in terms of patient wellbeing and reduced health care costs are likely to be considerable.
To
Know More About Novel Techniques in Arthritis & Bone Research Please Click
on:
